Free enterprise is still the greatest force for upward mobility, economic security, and the expansion of the middle class. We have seen in recent years what it’s like to have less free enterprise. As President, I will show the good things that can happen when we have more – more business activity, more jobs, more opportunity, more paychecks, more savings accounts.

Romney either ignored or failed to grasp that his experience with the free market is very different from the experiences of many people in the NAACP audience.

Mitt Romney’s solution is “the free market,” but many people in the NAACP audience for Mitt’s speech could probably have borrowed an old blues lyric to sum up their experience: “Your Free Market Ain’t Like Mine.”

For him, free enterprise is the answer to all of America’s problems. By free enterprise, he means de-regulation and low taxes for the rich corporations and people. He means trickle down economics. Those policies are not the solution. They are the problem. Those failed policies gave us the mortgage foreclosure crisis and soaring unemployment. Those policies gave us the recession.

That’s the problem with applying a “market-based solution” to a problem like health care. I can’t explain it any better than Republican Senator Chuck Grassley.

But Sen. Charles Grassley, a Republican from Iowa, questions whether dentists at corporate dental chains are free from corporate pressures to maximize profits. Grassley, the ranking member of the Senate Finance Committee, wouldn’t speak about Aspen Dental specifically, but he’s had committee investigators looking into the company and other private-equity-owned chains for months.

“Because when private equity firms get involved,” Grassley explained, “you got to understand that their motivation is to make money. And they are not dentists. And dentists ought to make the determination ’ of what is good for the teeth.’ Not some private equity manager in Wall Street.”

The problem is that there are populations that need services, but there’s no profit to be made in serving them. There are services that we as a country, at least until recently, have agreed that people should receive whether there’s a profit to be made or not. Health care is one of them. “Market-based” solutions require profit, and the only way to make a profit serving these populations is to overcharge, under-serve, or both.

It’s no coincidence that Deamonte Driver’s death for lack of a dentist became symbolic of the need for health care reform. Nor was it a coincidence that Marcellas Owens, whose mother died when he was just eight years old, after losing her job caused her to lose her health insurance, and her previous salary disqualified her from receiving Medicaid.

Health-care and higher education are similar in another way, too: People don’t think they can responsibly say no to either expense. Families take out hundreds of thousands of dollars of debt to pay medical bills and tuition costs. The only other cost that’s anything like that is housing — and it’s a much more optional expense. You can buy a house on your schedule. Health-care costs and your child’s 18th birthday tend to be somewhat less cooperative.

This inability to say no removes the ultimate form of market discipline: the consumer’s ability to simply walk out of the store. Oh, you can, at times, walk over to another store and try your luck there — though that’s not true if you’ve been brought into the ER in an ambulance, and it’s not true if your son only got into one decent college — but it tilts the power towards the sellers and away from the buyers.

There’s certainly more we could do to bring market pressures into play in both sectors, but the reason the government ends up involved in health care and education is that a real market would require us telling more people than we’re comfortable with that they can’t have the medical care or education that they need.

One thing we have so far agreed we should do together is to make up the difference, when the medical care someone can afford falls far short of the medical care they need. Many people in the audience for NAACP could look at “someone else’s child,” like Deamonte or Marcellas, and see their own child, or a child from their community, and want the same for “someone else’s child” that they’d want for their own — to get the medical care they need.

On health care, Biden compared what the Obama administration accomplished with health care reform, and the old status quo Republicans are determined to return us to.

“Health care. We see a future where everyone has access to affordable health care…

[Applause]

“Where seniors have access to prescription drugs at a lower cost, where they have access to preventive care – making their lives more livable and reducing costs, where insurance companies cannot deny coverage because of a pre-existing condition, where there are no limits on insurance policies, where children can stay with their parents on their policy until they’re 26, where Medicare is guaranteed and Medicaid is expanded.

[Applause, cheers]

“Where no American faces the prospect of a bankruptcy just because they get sick.

[Applause]

“Romney and his allies see health care a different way – controlled by the insurance companies – where pregnancy is a pre-existing condition, where coverage can be taken away if you get sick or hit your limit, where Medicare is voucherized,19 million people cut off of Medicaid, where 30 million Americans will have to wait for another generation before they have a chance for affordable decent health care.

The reality is that not all Democrats are progressive. The health care reform debate is illustrative of this divide, and the challenge progressives face with this political reality.

The difference depends on what you believe concerning health care. Is it an injustice that millions of Americans have little or no access to quality, affordable health care? Or is it merely unfortunate?

It depends on whether you believe health care is a right. It’s a generalization, but not too much of one, to say that progressives — many or most — believe that health care is a right; or, more specifically, that access to quality, affordable health care is a right. This makes health care a human rights or civil rights issue. It means that a system in which millions are without access to care is an unjust system.

What if you don’t believe that health care is a right? If you don’t believe that health care is a right, then it is not a human rights or civil rights issue. It means that millions of Americans being without health care is not an injustice. It may be unfortunate, but it’s not an injustice.

What does this matter? It matters, because an injustice and a merely unfortunate circumstance add up to to different levels of urgency. An injustice, to many people, is intolerable, and thus so is any delay in delivering justice.

Rep. David Dreier (R-Calif.) said on Monday evening that he didn’t believe highly expensive health care should be provided to uninsured patients with pre-existing conditions…

“While I don’t think that someone who is diagnosed with a massive tumor should the next day be able to have millions and millions and millions of dollars of health care provided, I do believe there can be a structure to deal with the issue of pre-existing conditions,” Dreier said.

What do you suppose he thinks should happen to this person? Does he think there should be some sort of ….death panel that decides whether he lives or dies? Or should we just assume that anyone with a deadly illness who doesn’t have enough insurance to pay for “millions and millions and millions” of dollars of health care should just be euthanized on the spot? Or perhaps they should be made to suffer. After all they failed to get rich enough or lucky enough to have adequate funds to pay for their needs so maybe it would be best to use some of these sickly parasites as cautionary tales.

Breathe deeply and try to summon your inner peace before reading this description, from economist Tyler Cowen, of what conservatives and libertarians should put in health care policy. You’re going to need every drop of calm and sanity you can muster.

2. A rejection of health care egalitarianism, namely a recognition that the wealthy will purchase more and better health care than the poor. Trying to equalize health care consumption hurts the poor, since most feasible policies to do this take away cash from the poor, either directly or through the operation of tax incidence. We need to accept the principle that sometimes poor people will die just because they are poor. Some of you don’t like the sound of that, but we already let the wealthy enjoy all sorts of other goods — most importantly status — which lengthen their lives and which the poor enjoy to a much lesser degree. We shouldn’t screw up our health care institutions by being determined to fight inegalitarian principles for one very select set of factors which determine health care outcomes.

I’m going to repeat that: “We need to accept the principle that sometimes poor people will die just because they are poor.”

History tells us that ignoring inequality tends to further entrench its insidious causes. It’s imperative that we begin an honest debate about the fundamental reality that health care access and outcomes in America are radically unequal.

Consider these facts:

Hispanics are twice as likely to die from diabetes. Tuberculosis strikes Asian Americans at 16 times the rate of whites. Cancer kills 35 percent more African-Americans than whites.

If two patients have similar heart disease, a black patient is one-third less likely to undergo life saving bypass surgery than a white patient.

Among preschool children hospitalized for asthma, only 7 percent of black and 2 percent of Hispanic children, compared with 21 percent of white children, are prescribed routine medications to prevent future asthma-related hospitalizations.

One of the most dramatic predictors of health is access to insurance and while 11 percent of whites are uninsured, about 32 percent of Latinos, 20 percent of blacks and 17 percent of Asian Americans have no health coverage.

This is the difference between conservatives and progressives on health care. For progressives, that “sometimes poor people will die just because they are poor” is a problem — one we can, and should, solve together. For conservatives, that “sometimes poor people will die just because they are poor” is a principle that be accepted.

Blog Authors

Terrance Heath is the Online Producer at Campaign for America's Future. He has consulted on blogging and social media consultant for a number of organizations and agencies. He is a prominent activist on LGBT and HIV/AIDS issues.

Bill Scher is the Online Campaign Manager at Campaign for America's Future, and the executive editor of LiberalOasis.com. He is the author of Wait! Don't Move To Canada!: A Stay-and-Fight Strategy to Win Back America, a regular contributor to Bloggingheads.tv and host of the LiberalOasis Radio Show weekly podcast. He has opinion articles that have been published by the New York Times, Minneapolis Star Tribune and Omaha World-Herald, and has made appearances on CNN, MSNBC and NPR among other TV and radio outlets.

Dave has more than 20 years of technology industry experience. His earlier career included technical positions, including video game design at Atari and Imagic. He was a pioneer in design and development of productivity and educational applications of personal computers. More recently he helped co-found a company developing desktop systems to validate carbon trading in the US.

Roger Hickey is Co-Director of the Campaign for America’s Future. He was also one of the founders of Health Care for America Now!, a coalition of over 1,000 national and local organizations united to achieve quality affordable health care for all. He was also one of the leaders of the successful campaign to stop the privatization of Social Security, called Americans United to Protect Social Security. Hickey was a founder and Communications Director of the Economic Policy Institute, a Washington think tank that looks at economics from the point of view of working Americans. He was also a founder of the Public Media Center in San Francisco. A graduate of the University of Virginia, Hickey began his career in the 1960s as an organizer for the Virginia Civil Rights Committee.

Isaiah J. Poole is communications director of People's Action, and has been the editor of OurFuture.org since 2007. Previously he worked for 25 years in mainstream media, most recently at Congressional Quarterly, where he covered congressional leadership and tracked major bills through Congress. Most of his journalism experience has been in Washington as both a reporter and an editor on topics ranging from presidential politics to pop culture. His work has put him at the front lines of ideological battles between progressives and conservatives. He also served as a founding member of the Washington Association of Black Journalists and the National Lesbian and Gay Journalists Association.

LeeAnn Hall is co-executive director of People's Action and People's Action Institute. A leader in social and racial justice organizing for more than 30 years, Hall has influenced and effected national reforms in health care, immigration policy, and fair pay. She has guided and inspired hundreds of young organizers into careers in social justice work. She was previously the founder and executive director of the Alliance for a Just Society. Hall lives in Seattle, Washington.

Robert L. Borosage is the founder and president of the Institute for America’s Future and co-director of its sister organization, the Campaign for America’s Future. The organizations were launched by 100 prominent Americans to develop the policies, message and issue campaigns to help forge an enduring majority for progressive change in America.
Mr. Borosage writes widely on political, economic and national security issues. He is a Contributing Editor at The Nation magazine, and a regular blogger at The Huffington Post. His articles have appeared in The American Prospect, The Washington Post,Tthe New York Times and the Philadelphia Inquirer. He edits the Campaign’s Making Sense issues guides, and is co-editor of Taking Back America (with Katrina Vanden Heuvel) and The Next Agenda (with Roger Hickey).

Miles Mogulescu is an entertainment attorney/business affairs executive, producer, political activist and writer. Professionally, he is a former senior vice president at MGM. He has been a lifelong progressive since the age of 12 when his father helped raise money for Dr. Martin Luther King, who was a guest in his home several times. More recently, he organized a program on single payer healthcare at the Take Back America Conference, a 2-day conference on Money in Politics at UCLA Law School, and “Made in Cuba,” the largest exhibition of contemporary Cuban art ever held in Southern California. He co-produced and co-directed "Union Maids," a film about three women union organizers in Chicago in the 1930s and '40s, which was nominated for an Academy Award for Best Feature Documentary.

Jeff Bryant is an Associate Fellow at Campaign for America's Future and the editor of the Education Opportunity Network website. Prior to joining OurFuture.org he was one of the principal writers for Open Left. He owns a marketing and communications consultancy in Chapel Hill, N.C. He has written extensively about public education policy.

About Terrance Heath

Terrance Heath is the Online Producer at Campaign for America's Future. He has consulted on blogging and social media consultant for a number of organizations and agencies. He is a prominent activist on LGBT and HIV/AIDS issues.